How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.62 | Professional | None | $1.26 | $1.26 | $1.62 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1.66 Median $2.09 Typical High $2.29 | Facility | None | $1.66 | $2.09 | $2.29 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $23.44 | Professional | None | $1.95 | $1.95 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.45 | Facility | None | $0.72 | $1.35 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Kaiser Permanente Setting Facility Modifier None Typical Low $2.14 Median $2.69 Typical High $3.98 | Facility | None | $2.14 | $2.69 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.14 Median $2.75 Typical High $4.68 | Professional | None | $2.14 | $2.75 | $4.68 |
Molina Setting Professional Modifier None Typical Low $1.55 Median $1.74 Typical High $1.91 | Professional | None | $1.55 | $1.74 | $1.91 |
Pacific Source Setting Facility Modifier None Typical Low $1.91 Median $2.19 Typical High $2.24 | Facility | None | $1.91 | $2.19 | $2.24 |
Premera BCBS Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Premera BCBS Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.14 | Professional | None | $1.86 | $1.86 | $2.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.40 | Professional | None | $1.78 | $1.95 | $2.40 |
United Setting Professional Modifier None Typical Low $0.87 Median $0.95 Typical High $1.86 | Professional | None | $0.87 | $0.95 | $1.86 |
Wellpoint Setting Professional Modifier None Typical Low $1.17 Median $1.58 Typical High $3.39 | Professional | None | $1.17 | $1.58 | $3.39 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.24 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.16 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | KX · Policy requirements met | $1.58 | $1.58 | $1.58 |
Where Washington sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington· 12th of 51
$1.95
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.